Given raised rates of patient suicide and violence in secure psychiatric facilities, staff in such settings are arguably at increased risk for burnout and reduced mental health. The present paper responds to the recent UK National Institute for Health and Care Excellence (NICE) call to assess workforce well-being. This paper held the following aims: (1) to quantify existing levels of mental health (i.e., depression, anxiety, distress, and post-traumatic stress) and subjective well-being (i.e., job satisfaction, life satisfaction, and four domains of burnout), and (2) to evaluate Coping Self-Efficacy (CSE) and Need for Affect (NFA) as factors associated with staff mental health and subjective well-being. We conducted a voluntary crosssectional health needs assessment of forensic mental health staff (N=170) between 2017 and 2018 from one National Health Service (NHS) Trust. Descriptive findings suggest staff possessed non-clinical average ranges of mental health symptoms. Subjective well-being findings showed burnout was relatively low, whereas job and life satisfaction were modest. Regression models demonstrated that: (a) thought/emotion stopping beliefs were negatively associated with psychological exhaustion; (b) social support beliefs were positively associated with life satisfaction and job enthusiasm; (c) NFA Avoidance was linked with poor mental health and burnout, and; (d) NFA Approach was positively associated with two health subjective well-being indicators. Overall, assessment results suggest NHS forensic mental health staff reported relatively good health. Cognitive-and emotion-focused coping beliefs demonstrate promise as content for prevention programming. Using Emotional Labour Theory, we offer psychological services-based recommendations for future prevention programming and research.

Embedding the best practice principles of clinical leadership development within a multidimensional model of clinical leadership provides a promising approach to: equipping the healthcare leader with those transferable leadership skills required to help them embark on a journey of lifelong leadership learning; and producing the healthcare leader who is caring, compassionate and can confidently and effectively transform community services.

Objective: The Suicide Competency Assessment Form (SCAF) provides a framework for suicide prevention skills training. This study assessed SCAF psychometric properties in a sample of behavioral health staff. Method: A cross-sectional survey of National Health Services (NHS) staff from varying disciplines (N=170) was conducted. Results: The SCAF yielded a one-factor structure with high internal consistency. Nursing assistants reported lower SCAF scores compared to other professionals. SCAF scores demonstrated positive associations with prior suicide prevention training, job enthusiasm, and several suicide/self-injury prevention outcome expectations (i.e., optimism working with self-harming patients and perceived ability to help self-harming patients). SCAF scores further demonstrated incremental validity in the form of multivariate model associations with suicide/self-injury prevention outcome expectations. Improved job satisfaction mediated the pathway from SCAF scores to perceived ability to help self-harming patients. Conclusion: The SCAF can be utilized in suicide prevention training and clinical supervision.

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Aims and methodWe explored the prevalence and use of constant supportive observations (CSO) in high, medium and low secure in-patient services in a single National Health Service (NHS) mental health trust. From clinical records, we extracted data on the length of time of CSO, the reason for the initiation of CSO and associated adverse incidents for all individuals who were placed on CSO between July 2013 and June 2014.ResultsA small number of individuals accounted for a disproportionately large proportion of CSO hours in each setting. Adverse incident rates were higher on CSO than when not on CSO. There was considerable variation between different settings in terms of CSO use and the reasons for commencing CSO.Clinical implicationsThe study describes the prevalence and nature of CSO in secure forensic mental health services and the associated organisational costs. The marked variation in CSO use between settings suggests that mental health services continue to face challenges in balancing risk management with minimising restrictive interventions.Declaration of interestA.B. and J.L.I. are both directly employed by the NHS trust in which the study was conducted.